Groundbreaking Surgery Performed on Fetus While the Mother's Uterus Is Outside Her Body
A pioneering operation involving a “fetoscope” recently took place at the Baylor College of Medicine and the Texas Children’s Hospital in Houston. Surgeons performed surgery on an unborn male fetus with spina bifida, while still in his mother’s womb.
“All right, it’s the real deal,” said Dr. Michael A. Belfort to the New York Times. Belfort is the chairman of obstetrics and gynecology at Baylor College of Medicine and obstetrician and gynecologist-in-chief of Texas Children’s Hospital.
The undertaking was intended to reverse the effects of spina bifida on the 24-week-old fetus. Spina Bifida is a condition where a baby’s spine and spinal cord fail to develop properly while in the womb, leading to complications such as traumatic birth, fluid buildup on the brain, paralysis of legs, risk of meningitis and more.
Science isn’t sure what causes the condition, but they do know that it begins in the early stages of pregnancy, within 3 to 5 weeks. Typically, surgeons will repair the spine within 28 hours of the birth, but only 20 percent of those patients can walk independently as they grow up.
Therefore, the medical community has been developing a procedure which allows surgeons to operate on the fetus before birth and ensure fewer complications, children who have had this repair still suffer from some bladder issues.
“The percent who benefit, I wish it was higher,” Dr. Whitehead said, adding that so far prenatal surgery does not seem to help with bladder incontinence, and most children with spina bifida need catheters to pass urine,” reports NYT.
A procedure to lessen the degree of disability has been performed on fetuses since the 1990s, but it was no cure. Now Dr. Belfort and assisting pediatric neurosurgeon, Dr. William Whitehead have come up with an experimental technique.
“The surgeons had made a wide incision in the mother’s lower abdomen, gently lifted out her uterus — still attached internally — and made two tiny, 4-millimeter slits. In one, they inserted a “fetoscope,” a small telescope fitted with a camera, light and grasping tool. The second slit was for other miniature instruments. Lit from within, the uterus glowed, red and magical in the darkened room,” writes reporter Denise Grady who was present in the room at the time.
The purpose of the operation is to prevent amniotic fluid from leaking into the exposed nerve tissue caused by the gap in the fetus’s spine, which is the leading cause of spina bifida complications.
"Closure of the spinal defect before birth reduces the risk of hydrocephalus and may improve motor function in select patients," Dr. Robert Bollo, a pediatric neurosurgeon at Texas Children's Hospital and assistant professor of neurosurgery at Baylor College of Medicine said in a statement from 2012. "Fetal surgery is an exciting new tool in our multidisciplinary commitment to the life-long care of patients with spina bifida."
Why do we do it, how can we stop it, and who else is at it?